Incontinence Drugs Flashcards Preview

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Flashcards in Incontinence Drugs Deck (4)
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1
Q

N+V treatment in pregnancy

A
  1. Promethazine (anti-histamine)
  2. Ginger + P6 wrist accupuncture
2
Q

Stress Incontinence

Management

A
  • Conservative
    • Loos weight, address cough
    • Pelvic floor muscle training 3m physio
    • Vaginal ‘cones’/ sponges
  • Medical
    • Duloxetine SNRI - enhances sphincter control via CNS
  • Conservative
    • Tension-free vaginal tape (TVT)
      [over pubis]
    • Trans-obturator tape (TOT)
      [through obturator foramen]
    • Injectable periurethral bulking agents
3
Q

Urge incontinence

Management

A
  • Conservative
    • Bladder retaining min 6wks (inc time between voids)
  • Medical
    • Antimuscarinics
      • Oxybutynin
      • Tolterodine (less dry mouth)
      • Solifenacin
    • Post-menopause: Intravaginal Oestrogens
  • Surgical
    • Neuromodulation + S3 nerve stimulation
    • Botolinum toxin A injections (idiopathic only)
    • Augmentation cystoplasty
4
Q

Antimuscarinics

  • Mechanism
  • Indications
  • SEs
A

Mechanism - block muscarinic acetylcholine receptors

Indications

  • Bradycardia
    • Atropine (blocks M2 parasym to SA node)
    • IM/SC: initial M1 presynaptic block prevents reuptake⇒ bradycardia
  • Urge incontinence
    • Oxybutynin
    • Tolteradine
    • Solifenacin
  • Bronchodilators
    • Ipratropium bromide
    • Triotropium
  • Parkinsonism - tremor + rigidity
    • Procyclidine
    • Benztropine
    • Trihexyphenidyl (benzhexol)
  • Anti-psychotic drug extra-pyramidal SEs
    • Procyclidine
  • IBS anti-spasmodic (only works on bowel muscle)
    • Mebeverine
    • Alverine